
How Self Funded Health Insurance Works
Self-funded health insurance lets employers pay claims directly, capture savings when employees stay healthy, and see exactly where every dollar of spend goes.
Explore our blog resources to help employers and advisors understand the value of captive insurance.

Self-funded health insurance lets employers pay claims directly, capture savings when employees stay healthy, and see exactly where every dollar of spend goes.

Per-employee-per-year (PEPY) cost is the truest benchmark for whether your health plan is competitive. Here’s how to use it to drive decisions.

Specialty drugs are the fastest-growing line item in employee benefits. A self-funded plan gives you the visibility and levers to manage the spend.

Budgeting a self-funded health plan means understanding fixed and variable costs. Here’s how to plan spend and unlock savings through a group captive.

Lowering prescription drug prices takes more than negotiating with PBMs. Self-funded employers can stack DPC, transparency, and direct contracting to control total spend.

Your pharmacy benefit manager makes or breaks drug spend. Here’s how self-funded employers choose a PBM aligned with their interests, not the PBM’s.

Self-funded health plans pay off when employers commit to a long-term view, riding through short-term claims volatility to capture compounding

Finding the best stop loss captive for your employee health plan comes down to underwriting, claims transparency, surplus return, and

Insights from self-funded employers on what works: claims transparency, vendor flexibility, and clinical care management that actually moves the cost

Keeping premiums affordable starts with claims transparency and ends with structural cost containment. Self-funded plans are built for both.

Self-funded insurance lowers cost by giving employers claims transparency, vendor flexibility, and the ability to act directly on data instead

Self-funded healthcare gives small and mid-market employers a way to take back control of cost, coverage, and the long-term health

Provider network choice shapes employee care, plan costs, and out-of-pocket spend. Here’s how self-funded employers pick the right one.

Pharmacy costs are rising faster than any line item in your health plan. Here’s how to choose a PBM that

Per-employee-per-year (PEPY) cost is the truest benchmark for whether your health plan is competitive. Here’s how to use it to

Your pharmacy benefit manager makes or breaks drug spend. Here’s how self-funded employers choose a PBM aligned with their interests,

A third-party administrator (TPA) is the backbone of any self-funded plan. Here’s how a TPA processes claims, manages eligibility, and

Finding the right TPA shapes claims accuracy, employee experience, and total spend. Here are 8 secrets self-funded employers use to

Wellness programs deliver measurable ROI through reduced claims, lower absenteeism, and stronger productivity. See how self-funded employers track and prove

For most CFOs, healthcare costs now eat directly into profitability. This Roundstone leadership study shows where the spend goes and

Healthcare cost containment finds waste, removes it, and keeps outcomes intact. Self-funded plans give you the claims data to do

Self-funding gives you the control, claims visibility, and flexibility to attack the cost drivers that fully insured plans actively hide

Effective cost containment starts with claims data, clinical care management, pharmacy optimization, and direct primary care partnerships working as one

Real healthcare cost savings come from claims transparency, smart vendor choices, and proactive clinical management. Self-funding makes all three possible.

If renewal season has you bracing for a double-digit increase, it’s time to look at self-funding. Here’s how the model

Renewal season is the moment benefit advisors prove their value. Here’s how to prepare with claims data, scenario modeling, and

Introducing self-funded health insurance to employees is mostly about communication. Here’s how to explain the model, the value, and what

Well-being programs improve employee health while reducing benefit cost. Here’s how strategic incentives drive participation and engagement that actually sticks.

It’s hiring season. Top talent expects benefits that show employers actually invested in employee health. Here’s how self-funding helps you

Cultivating a culture of healthcare consumerism takes employee education, transparent tools, and steady communication. Here’s how to engage your team.

Employers can use wellness programs to improve employee health while controlling cost. Here’s how to launch a well-being program that
Self-funding means an employer pays for their employees’ healthcare claims directly instead of paying fixed premiums to an insurance carrier.
A medical group captive is a self-funded model where small and mid-sized employers join together to access financial advantages, share risk and gain greater stability.
Stop-loss insurance protects self-funded employers from large or unexpected claims. It caps financial risk so one high-cost event doesn’t significantly impact your overall healthcare spend.
Health insurance costs rise due to increasing healthcare prices, higher utilization, and lack of transparency in traditional models. Learn how self- funding through a captive can help offset these trends.
Cost containment includes strategies that reduce unnecessary healthcare spending while maintaining quality care. Read how tactics like claims analysis, preventative care, and pharmacy cost management can reduce spend.
Join us live or watch pre-recorded discussions, expert panels, and educational sessions designed for employers and advisors.
Hear candid conversations and real-world insights from industry experts shaping the future of healthcare funding.
Explore in-depth guides covering captive insurance, healthcare costs, and strategies for long-term savings.
Stay informed with monthly insights on captive insurance, cost control, and smarter benefit strategies.